MEDICARE: MAUREEN PARNIN SIZEMORE ATC, PTA, EMT-B

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	AT00537	OH

General Provider Information

NPI Number	:	1093737314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN PARNIN SIZEMORE ATC, PTA, EMT-B

Provider Business Mailing Address
First Line	:	4494 LILAC RD
Second Line	:
City	:	SOUTH EUCLID
State	:	OH
Zip	:	44121-3903
Country	:	US
Telephone Number	:	216-291-4934
Fax Number	:

Provider Business Practice Location Address
First Line	:	1911 W 30TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-3495
Country	:	US
Telephone Number	:	216-651-0222
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	01/09/2024

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